Objective To analyze the death status and main causes of death among children under 5 years old in Changsha from 2016 to 2021, and to provide a scientific basis for formulating preventive measures for children's health care. Methods The data of 1 761 deaths of children under 5 years old in Changsha City from 2016 to 2021 were collected, and the mortality trend, the order of causes of death and the utilization of pre-death medical care services were retrospectively analyzed. Results The 7-day neonatal mortality, 28-day neonatal mortality, 0-1-year-old neonatal mortality, and the mortality rate of children under 5 years old (U5MR) in Changsha City from 2016 to 2021 were 0.76‰, 1.28‰, 2.41‰, and 3.86‰, respectively. All the mortality rates showed a decreasing trend (P<0.05). U5MR in males was significantly higher than that in females (P<0.05), and U5MR in rural areas was significantly higher than that in urban areas (P<0.05). The top five causes of U5MR were drowning, premature delivery or low birth weight, pneumonia, other congenital anomalies, and accidental asphyxia, respectively. The death places of children under 5 years old were mainly medical and health institutions, and 81.72% of them were treated in hospitals before death. Conclusion From 2016 to 2021, the mortality rate of children under the age of 5 in Changsha City has gradually decreased. Preventing congenital malformations, reducing preterm birth or low birth weight, improving the treatment level of pneumonia, and preventing accidents such as drowning and accidental suffocation are the key to reducing the mortality rate of children under 5 years old.

Aiming at the obstacle avoidance in simulated prosthetic vision,an improved instance segmentation model SOLOv2-RS is proposed for providing a basis for implant recipients to accurately perceive the relevant instance objects of navigation tasks in low-resolution prosthetic vision.According to the visual attention mechanism,the distance from the center of the visual field and the target scale are adopted as the importance calculation criteria for each instance,and the obtained importance score is used as the basis for the hierarchical representation of the obstacles to be avoided.Meanwhile,edge information is used to cue the tactile paving,and it is morphologically inflated for avoiding the edge information loss caused by the limited phosphene.The prosthetic vision simulation results demonstrate that the hierarchical optimization processing strategy for simulated prosthetic vision can effectively achieve the optimal representation of tactile paving and obstacles,thus facilitating the implant recipients to accomplish outdoor obstacle avoidance tasks more efficiently,and providing ideas for the research on the image processing of visual prosthetic devices.

Objective: To gain an in depth understanding of the cognitive appraisal of middle school students with mental illness after experiencing childhood trauma, so as to provide a reference for the development of effective interventions. Methods: From March to September in 2023, 21 middle school students with childhood trauma experiences and mental illnesses were selected from outpatient and inpatient departments through purposive sampling in a tertiary grade A psychiatric hospital in Wuhan. Semistructured interviews were conducted and the seven steps of Colaizzi phenomenology were used to analyze the data and extract themes. Results: A total of 3 themes and 11 subthemes were extracted:insufficient awareness of childhood trauma (lack of selfawareness, lack of awareness of primary caregivers), multiple hurtful experiences after experiencing childhood trauma (complex negative affective experiences, multiple physical discomfort, pessimistic attitudes toward life, social impairment, and academic impairment), and influences on childhood trauma experiences (personality traits, inappropriate personal coping styles, poor upbringing environment, and difficulty in obtaining social support). Conclusions Middle school students with mental illnesses and their caregivers generally lack knowledge about childhood trauma, which brings widespread harm and are affected by multiple factors. It should jointly strengthen the popularization of scientific knowledge, intervene in a timely manner, and thereby reduce the adverse consequences of childhood trauma experiences.

ObjectiveTo assess the clinical efficacy and regulation of skin microbiota in children with atopic dermatitis and damp-heat accumulation syndrome treated by Zhaqu Xiaofeng Powder （楂曲消风散， ZXP）. MethodsNinety children were randomized into a treatment group and a control group， each with 45 children. The treatment group received ZXP orally， while the control group received levocetirizine hydrochloride syrup， both for 4 weeks. The atopic dermatitis severity index （SCORAD）score， visual analog scale （VAS）score for itching， children dermatology life quality index （CDLQI）score， and traditional Chinese medicine syndrome score were assessed before and after 2- and 4-week treatment. Simultaneously， adhering to the principles of sample size in microbial sequencing， 25 children were randomly selected from each group （total 50 children）； skin samples were collected before and after treatment， and skin specimen DNA was extracted for 16S rRNA gene amplifier sequencing； the skin microbiota levels were detected， and the distribution of bacteria， diversity of flora， and differences between groups were compared. ResultsThere were five drop-outs in each group， and 40 cases in each group were included in final analysis. After 2- and 4-week treatment， both groups showed a significant reduction in SCORAD scores， VAS scores， and CDLQI scores， and more reductions were shown after 4-week treatment than 2-week treatment （P＜0.01）. The SCORAD score， VAS score， and CDLQI score of the treatment group were significantly lower than those in the control group after 4-week treatment （P＜0.01）. The scores of upset， thirsty， poor appetite， short red urine， and dry stool were reduced in the treatment group （P＜0.05）， while the scores of thirsty， poor appetite， short and red urine decreased after treatment （P＜0.05）. After 4 weeks of treatment， among the differential genera with abundances ＞0.5% in the treatment group， The cumulative relative abundances of Staphylococcus aureus， Streptococcus_mitis， Escherichia coli and Gemella_haemolysans in the treatment group were downregulated after treatment； in the control group， there was a relative cumulative decrease in the abundance of Streptococcus_mitis. The control group had reduced relative abundance of Streptococcus_mitis， Escherichia coli， Staphylococcus aureus and Gemella_haemolysans， after treatment （P＜0.05）. Alpha diversity analysis revealed an increase in both Chaol index and Shannon index after treatment （P＜0.05）， while there was no significant difference in Chaol index and Shannon index in the control group before and after treatment （P＞0.05）. Higher Chaol index and Shannon index were found in the treatment group （P＜0.05）. Beta diversity analysis showed that there were significant differences in the microbial community structure at the lesion site between the treatment group and the control group before treatment. The microbial community structure in the treatment group was similar after treatment， while there was no significant change in the microbial community structure in the control group before and after treatment. There were significant structure differences of key bacteria genus in both groups before and after treatment. ConclusionZXP used in the treatment of pediatric atopic dermatitis （AD）with the syndrome of damp-heat accumulation， has shown efficacy in reducing the severity of skin lesions， alleviating itching， and enhancing the quality of life in children. This modulation aims to decrease the abundance of pathogenic bacteria while promoting the colonization of beneficial bacteria， thereby altering the skin microbiota and contributing to the treatment of pediatric AD.

Background Workers engaged in benzene-exposed or benzene-containing solvent-exposed operations in China are predominantly subjected to a low concentration of benzene series compounds, and prolonged exposure to low concentrations of benzene, toluene, and xylene (BTX) may have implications for blood pressure. Objective To investigate the influence of low-concentration BTX exposure on the blood pressure of workers, aiming to provide a basis for enterprises to devise associated health management strategies to mitigate the occurrence of hypertension among workers exposed to low concentrations of BTX. Methods Using a cross-sectional design, 884 workers from a petroleum refining enterprise in Hainan who participated in an occupational health examination in 2022 were selected as the study population, and were divided into an exposure group of 649 workers and a control group of 235 workers based on their reporting of BTX exposure or not. Data on workplace BTX concentrations and health examinations of the study subjects were collected and questionnaires were administered. In addition, S-phenylmercapturic acid (S-PMA), hippuric acid (HA), and methyl hippuric acid (MHA, including the three isomers 2-MHA, 3-MHA, and 4-MHA) were measured in the urine of the workers using high-performance liquid chromatography-tandem triple quadrupole mass spectrometry to assess internal BTX burden. The effects of low-concentration BTX exposure on blood pressure were analyzed. Results In 2022, the concentrations of benzene, toluene, and xylene of all monitoring points did not exceeded the national limits by either time-weighted average (TWA) or short-term exposure limit (STEL), indicating low-concentration BTX exposure. Regarding the internal burden of BTX, the concentrations of benzene metabolite S-PMA, toluene metabolite HA, and xylene metabolites 3-MHA and 4-MHA in the urine samples in the exposure group were higher than those in the control group (P < 0.05). The correlation analysis showed a positive correlation between urinary S-PMA concentration and diastolic blood pressure in the workers (r=0.265, P < 0.05). Differences in systolic and diastolic blood pressure distributions were statistically significant among workers grouped by sex, age, work years, educational levels, monthly income, body mass index (BMI), alcohol use, dietary oil, and types of residential address (P < 0.05). Significant differences in systolic blood pressure distribution were observed among workers by smoking status and levels of labor intensity (P < 0.05). Compared with the control group, the workers in the exposure group exhibited a significant increase in diastolic blood pressure (P < 0.05). The results of multiple linear regression showed that age, sex, and BMI had statistically significant effects on systolic blood pressure (P < 0.05), while age, work years, and BMI had statistically significant effects on diastolic blood pressure (P < 0.05). The systolic blood pressure of age > 35 years, male, overweight and obese workers was significantly higher than that of age ≤ 35 years, female, and underweight workers, and the diastolic blood pressure of age > 35 years, work years > 5 years, and obese workers was higher than age ≤35 years, ≤5 years of service, and underweight workers. Low-concentration BTX exposure was one of the main influencing factors for elevated diastolic blood pressure, and the exposed workers showed a 1.337 mmHg increase in diastolic blood pressure compared to the control group (P < 0.05). Conclusion Low-concentration BTX exposure, work years > 5 years, and obesity may elevate blood pressure among petroleum refininig workers. Regular blood pressure monitoring and enhanced health interventions for this occupational group are warranted.

Objective To analyze the situation of perinatal birth defects in 13 monitoring hospitals in Changsha City from 2011 to 2020, and to explore the composition characteristics and changes of birth defects in Changsha. Methods The monitoring data of perinatal birth defects in 13 surveillance hospitals in Changsha City from 2011 to 2020 were collected and statistically analyzed. Results From 2011 to 2020, the total number of perinatal infants in the 13 surveillance institutions in Changsha was 541,234, showing a trend of rising first and then falling. A total of 15 725 cases of birth defects were found, and the incidence rate of birth defects in perinatal period was 290.54/10 000. The incidence of birth defects in 2020 decreased by 41.93% compared with 2011. The incidence of perinatal birth defects in males (326.59/10,000) was higher than that in females (248.96/10 000), and the difference was statistically significant (χ²=288.955, P＜0.05). The incidence of perinatal birth defects in urban areas (312.65/10,000) was higher than that in rural areas (262.26/10 000), and the difference was statistically significant (χ²=119.974, P＜0.05). The incidence of birth defects in perinatal infants born to mothers under 20 years old was higher than that in other age groups. The top five major birth defects were congenital heart disease, polydactyly, external ear malformation, clubfoot, and hypospadias. Conclusion The incidence of perinatal birth defects in Changsha shows an overall downward trend , and the prevention and control measures for birth defects have shown effectiveness. To consolidate the achievements and control the incidence at a low level, the tertiary prevention of birth defects should be further strengthened.

Objective This study aimed to evaluate the associations of serum folate and/or vitamin B12 concentrations with obesity among Chinese children and adolescents. Methods A cross-sectional study was conducted including 3,079 Chinese children and adolescents,aged 6 to 17 years,from Jiangsu,China.Anthropometric indices,such as,children's body mass index(BMI),BMI z-scores,waist circumference,and waist-to-height ratio were utilized.Multivariable linear regression and generalized additive models were used to investigate the associations of serum folate and vitamin B12 levels with anthropometric indices and odds of obesity. Results We observed that serum vitamin B12 concentrations were inversely associated with all anthropometric indices and the odds of general obesity[odds ratio(OR)= 0.68;95%confidence interval(CI)= 0.59,0.78]and abdominal obesity(OR = 0.68;95%CI = 0.60,0.77).When compared to participants with both serum vitamin levels in the two middle quartiles,those with both serum folate and vitamin B12 levels in the highest quartile were less prone to general(OR = 0.31,95%CI = 0.19,0.50)or abdominal obesity(OR = 0.46,95%CI = 0.31,0.67).Conversely,participants with vitamin B12 levels in the lowest quartile alongside folate levels in the highest quartile had higher odds of abdominal obesity(OR = 2.06,95%CI = 1.09,3.91). Conclusion Higher serum vitamin B12 concentrations,but not serum folate concentrations,were associated with lower odds of childhood obesity.Children and adolescents with high levels of vitamin B12 and folate were less likely to be obese.

In recent years,the application of long non-coding RNAs(lncRNAs)in the treatment of dis-eases has been widely concerned.LncRNAs have been proved to play a crucial role in tumor therapy.They usually act as oncogene or suppressor genes to regulate the occurrence and development of tumors.Previously,our group discovered a new lncRNA 606938 that can be used as a target in colorectal cancer through transcriptome analysis.However,its molecular mechanism in colorectal cancer is still unclear.In this study,RT-qPCR test shows that lncRNA 606938 is low expressed in colorectal cancer cell lines com-pared with normal colon epithelial cells.The clonogenicity was decreased by 97％and 54.5％in lncRNA 606938 overexpressed DLD-1 and SW620 cells,respectively.The results of flow cytometry assay showed that overexpression of lncRNA 606938 caused cell cycle arrest at G1 phase(They were prolonged by 50.5％and 63.9％,respectively)and promoted apoptosis of colorectal cancer cells,which was increased by 1.9％and 3.3％,respectively.Western blot results showed that overexpression of lncRNA 606938 down-regulated the expression of related oncogenes(β-catenin,c-Myc,cyclin D1,cyclin D2,cyclin D3,CDK 4,CDK 6)in colorectal cancer cells,and the expression of tumor suppressor genes(TRIM33,caspase 2,and actived caspase 3)was up-regulated.The above results were reversed after knockdown of lncRNA 606938.Mechanistically,it has been confirmed through RNA pulldown assay,RIP assay,and Rescue assay that lncRNA 606938 can target and promote TRIM33 expression,thereby promoting the degradation of β-catenin and blocking the expression of β-catenin and its downstream oncogenes such as c-Myc and cycline D1 to inhibit the progression of colorectal cancer.This study elucidates the molecular mechanism by which the lncRNA 606938 targets TRIM33/β-catenin signaling pathway,inhibits the pro-liferation and promotes the apoptosis of colorectal cancer cells.This study reveals the potential of lncRNA 606938 as a tumor suppressor gene,providing new target and strategies for the clinical treatment of color-ectal cancer.

Upon penetration into the host organism,the decapsulated larvae(intestinal infective stage 1 larvae)of Trichinella spiralis(T.spiralis)proceed to invade the host's small intestinal epithelial cells to continue their development,which is a critical step for T.spiralis infection and pathogenesis.Based on our prior research,the Ts-DNase Ⅱ-7 protein,which is present in the adult stage of T.spiralis,has a role in promoting the parasite's invasion of the intestinal epithelium.This is achieved by disrupting the integrity of the intestinal barrier,consequently promoting the parasitization of these cells in the host organism.Ts-DNase Ⅱ-7 can induce differential expression of various miRNAs,among which miR-142-5p has been reported to be involved in disrupting the intestinal barrier.Therefore,in this study,we investigated the mechanism by which Ts-DNase Ⅱ-7-induced miR-142-5p regulates intestinal epithelial cell barrier function by affecting target genes.The experiment was divided into Ts-DNase Ⅱ-7-treated group,miR-142-5p overexpression group(OE),miR-142-5p inhibition group(Inhibition),negative control group(NC)and control group(Control),lentiviral vectors for overexpression and suppression of miR-142-5p expression were used to infect human colorectal adenocarcinoma cells Caco-2 at an MOI of 80,and puromycin(8 mg/L)was used to screen cells to obtain cell lines that stably suppressed the expression of miR-142-5p and cell lines that miR-142-5p was overexpressed,cell transfection efficiency was assessed by fluorescence microscopy,and the relative expression of miR-142-5p was detected by RT-qPCR in each group of cells.The target gene Claudin-1(CLDN1)was predicted and validated using miR target prediction database,RT-qPCR,Western blot and dual luciferase assay.HE staining,Western blot and quantitative analysis of monolayer transmembrane electrical resistance(TEER)and FITC permeability were then applied to elucidate the mechanism of action of miR-142-5p.Caco-2 cells were lentivirally infected and successful transfection was verified by fluorescence microscopy and RT-qPCR.Dual luciferase and Western blot results showed that CLDN1 was a direct target gene of miR-142-5p(P＜0.001).Compared to the Ts-DNaseⅡ-7 alone treatment group and the OE+Ts-DNase Ⅱ-7 group,the miR-142-5p inhibited expression group and alleviated Ts-DNase Ⅱ-7-induced down-regulation of CLDN1 mRNA and protein levels(P＜0.01 and P＜0.05,respectively)and re-versed the decrease in TEER and elevated permeability(P＜0.01).Ts-DNase Ⅱ-7 up-regulates miR-142-5p expression,causing reduced CLDN1 expression and impaired intestinal barrier function in Caco-2 monolayer cells,which in turn promotes T.spiralis invasion of the intestinal epithelium to achieve further development.

Objective To investigate the occurrence of adverse events of lurasidone in the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS)database by using Open Vigil FDA2.1,to enrich the experience and provide the basis for the clinical use of the drug in China.Methods Using Open Vigil FDA2.1,adverse event data were extracted from the FAERS database for a total of 51 quarters from the 4th quarter of 2010 to the 3rd quarter of 2023,and the ratio of reporting ratio(ROR)method and the proportional reporting ratio(PRR)method were used for data mining and analysis.Results A total of 32 728 adverse event reports with lurasidone as the first suspected drug was obtained,with a larger proportion of females(54.26％)and occurring mostly in adults(18 to 59 years).After the screening,326 preferred term(PT)signals were obtained,involving 20 system-organ classifications(injury,poisoning and procedural complications,general disorders and administration site conditions,psychiatric disorders,etc.).Among them,PTs with the higher frequency of occurrence included off label use,feeling abnormal,crying,anxiety,depression,insomnia,etc.PTs with stronger signal strength included activation syndrome,mania,tongue movement disturbance,hypoprolactinaemia,akathisia,etc.Multiple new suspected adverse drug reactions were unearthed,including hypoprolactinaemia,emotional poverty,stiff tongue,etc.Conclusion Lurasidone has a favorable safety profile,and women need to closely monitor prolactin levels when taking this medication.The drug is relatively safe for use in pregnant,puerperal and perinatal women and patients with poor metabolic function.Hypoprolactinaemia and restless leg syndrome are new rare suspected adverse events with lurasidone.